Dr. James M. Hurst: Quality trauma care

By Dr. James M. HurstSpecial to The Sun

Published: Sunday, January 13, 2013 at 6:01 a.m.

Last Modified: Friday, January 11, 2013 at 11:39 p.m.

As a trauma surgeon with 35 years of experience, I have seen and treated all types of patients with a variety of life-threatening, traumatic injuries. Regardless of whether the trauma patient is a toddler who fell down the stairs, a grandparent who was in a car crash or an adult with a potentially fatal gunshot wound, the reality is that high-quality, readily accessible trauma care is critical to maximize survival and limit disability.

Time is the most precious commodity in treating traumatic injuries. Modern trauma centers are staffed, equipped and organized to get critically injured patients specialized care as quickly and efficiently as possible. No matter how efficient the care, however, patients have the best chance for survival when they receive trauma care within 60 minutes of their injury. The fact remains that only 38 percent of Florida's trauma patients are treated in designated trauma centers, well below Florida's published goal of 65 percent.

That is the problem the University of South Florida and Hospital Corporation of America committed to take on when we formed the USF HCA Trauma Network in 2010. The statewide network opened six trauma centers in underserved areas where independent needs assessments so indicated. The most recent opening was at Ocala Regional Medical Center in December 2012.

Unfortunately, the success of the network in bringing high-quality trauma care to underserved areas has also made us a target for criticism and even legal challenges. The challenges come from hospitals that operate trauma centers outside the trauma service area, such as Shands at the University of Florida, Shands Jacksonville and Jackson Memorial, but also from Munroe Regional in Ocala, which does not offer a trauma center.

These hospitals see Florida's new, statewide network as unwanted and unnecessary competition with their own trauma centers and business objectives. Their latest legal challenges even ask the state to take the extraordinary measure of taking away the trauma center at Ocala Regional Medical Center, which is the first and only trauma center in that trauma service area. This action would deprive Floridians in Marion, Hernando and Citrus counties of expedited access to much-needed trauma care. In fact, a 2010 study published by the Department of Health showed these counties are the most underserved areas for trauma in all of Florida.

The USF HCA Trauma Network was created to provide life-saving trauma care to patients in parts of the state where that type of care was most needed. The public need for each trauma center in the network was certified by the Florida Department of Health. Ocala is a prime example of where the needs of our state are being met by the network. The trauma center at Ocala Regional Medical Center is providing critical care to the most underserved area in our state.

Prior to the opening of the new trauma center at Ocala Regional Medical Center, seriously injured patients would be transported to Gainesville or Tampa. The 300 patients a year who were sent to those cities by ambulance or helicopter can now be treated in a fully functional local center within minutes. True, that means 300 fewer admissions for hospitals in Gainesville and Tampa, but much more importantly, it means improved survival chances for 300 Floridians. We have already witnessed the lives of many people being saved in the local community as a direct result of this new trauma center.

Traumatic injuries are the leading cause of death for all Americans under age 44. Florida's health care providers should concentrate on developing the best means of fighting this killer, not on fighting turf battles with each other. Furthermore, this network is the first of its kind and will advance the field of trauma. It will be central to building high-quality, coordinated care throughout the state of Florida, creating a model for other states and networks to emulate. We should all work together to build the best trauma system in the country for the sake of saving the most lives and making a positive difference in our communities.

Dr. Hurst is the medical director of the USF HCA Trauma Network and a professor of surgery at the University of South Florida.

<p>As a trauma surgeon with 35 years of experience, I have seen and treated all types of patients with a variety of life-threatening, traumatic injuries. Regardless of whether the trauma patient is a toddler who fell down the stairs, a grandparent who was in a car crash or an adult with a potentially fatal gunshot wound, the reality is that high-quality, readily accessible trauma care is critical to maximize survival and limit disability. </p><p>Time is the most precious commodity in treating traumatic injuries. Modern trauma centers are staffed, equipped and organized to get critically injured patients specialized care as quickly and efficiently as possible. No matter how efficient the care, however, patients have the best chance for survival when they receive trauma care within 60 minutes of their injury. The fact remains that only 38 percent of Florida's trauma patients are treated in designated trauma centers, well below Florida's published goal of 65 percent.</p><p>That is the problem the University of South Florida and Hospital Corporation of America committed to take on when we formed the USF HCA Trauma Network in 2010. The statewide network opened six trauma centers in underserved areas where independent needs assessments so indicated. The most recent opening was at Ocala Regional Medical Center in December 2012. </p><p>Unfortunately, the success of the network in bringing high-quality trauma care to underserved areas has also made us a target for criticism and even legal challenges. The challenges come from hospitals that operate trauma centers outside the trauma service area, such as Shands at the University of Florida, Shands Jacksonville and Jackson Memorial, but also from Munroe Regional in Ocala, which does not offer a trauma center.</p><p>These hospitals see Florida's new, statewide network as unwanted and unnecessary competition with their own trauma centers and business objectives. Their latest legal challenges even ask the state to take the extraordinary measure of taking away the trauma center at Ocala Regional Medical Center, which is the first and only trauma center in that trauma service area. This action would deprive Floridians in Marion, Hernando and Citrus counties of expedited access to much-needed trauma care. In fact, a 2010 study published by the Department of Health showed these counties are the most underserved areas for trauma in all of Florida.</p><p>The USF HCA Trauma Network was created to provide life-saving trauma care to patients in parts of the state where that type of care was most needed. The public need for each trauma center in the network was certified by the Florida Department of Health. Ocala is a prime example of where the needs of our state are being met by the network. The trauma center at Ocala Regional Medical Center is providing critical care to the most underserved area in our state. </p><p>Prior to the opening of the new trauma center at Ocala Regional Medical Center, seriously injured patients would be transported to Gainesville or Tampa. The 300 patients a year who were sent to those cities by ambulance or helicopter can now be treated in a fully functional local center within minutes. True, that means 300 fewer admissions for hospitals in Gainesville and Tampa, but much more importantly, it means improved survival chances for 300 Floridians. We have already witnessed the lives of many people being saved in the local community as a direct result of this new trauma center.</p><p>Traumatic injuries are the leading cause of death for all Americans under age 44. Florida's health care providers should concentrate on developing the best means of fighting this killer, not on fighting turf battles with each other. Furthermore, this network is the first of its kind and will advance the field of trauma. It will be central to building high-quality, coordinated care throughout the state of Florida, creating a model for other states and networks to emulate. We should all work together to build the best trauma system in the country for the sake of saving the most lives and making a positive difference in our communities.</p><p><i>Dr. Hurst is the medical director of the USF HCA Trauma Network and a professor of surgery at the University of South Florida. </i></p>